Long-Term Blood Pressure Control Effect of Celiac Plexus Block with Botulinum Toxin

Area of Science:

• Interventional Pain Management
• Cardiovascular Medicine
• Neurology

Background:

• Resistant hypertension (RHTN) poses a significant challenge, often requiring multidisciplinary treatment approaches.
• Conventional antihypertensive drugs and procedures like renal denervation may fail in some RHTN cases.
• Celiac plexus block (CPB) is an established intervention for managing abdominal pain and is explored here for hypertension.

Observation:

• An 18-year-old male presented with severe RHTN refractory to multiple antihypertensive medications and renal denervation.
• The patient was referred for celiac plexus block (CPB) as a potential therapeutic option.
• CPB was performed using botulinum toxin and local anesthetics.

Findings:

• Celiac plexus block with botulinum toxin effectively controlled the patient's systolic blood pressure.
• Systolic blood pressure was maintained at approximately 150 mmHg for a minimum of three months post-procedure.
• The intervention provided significant and sustained BP reduction in a treatment-resistant case.

Implications:

• Botulinum toxin-mediated CPB represents a promising, minimally invasive option for managing refractory RHTN.
• This case highlights the potential of neurolytic blockade in addressing complex cardiovascular conditions.
• Further research is warranted to establish the efficacy and safety profile of CPB with botulinum toxin for RHTN.